Deans' stroke musings: Mood Disorders of Years Past Contribute to Stroke Risk for Some

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Wednesday, March 22, 2023

Mood Disorders of Years Past Contribute to Stroke Risk for Some

It is COMPLETELY YOUR STROKE DOCTOR'S RESPONSIBILITY TO HAVE 100% RECOVERY PROTOCOLS TO PREVENT DEPRESSION!

Mood Disorders of Years Past Contribute to Stroke Risk for Some

Study suggests causal role of depression, bipolar disorder in women

by Nicole Lou, Senior Staff Writer, MedPage Today March 22, 2023

A computer rendering of a transparent head with blood loss to the brain highlighted

Genetic susceptibility to mood disorders may also play a causal role in stroke, according to a population-based prospective cohort study in Sweden.

A higher polygenic risk score (PRS) for mood disorders consistently tracked with both all strokes and ischemic strokes over more than 20 years of follow-up. Notably, there was an interaction by sex such that this observation applied only to women, not men, reported Isabel Gonçalves, MD, PhD, of Lund University in Malmö, Sweden, and colleagues.

Women had increasing stroke risk when polygenic risk for mood disorders was either analyzed by quintiles (HR 1.45 for highest vs lowest quintile, 95% CI 1.21-1.74) or as a continuous variable (HR 1.13 per 1 SD increase, 95% CI 1.07-1.19), the study authors showed in Strokeopens in a new tab or window.

Furthermore, Mendelian randomization analyses provided evidence that mood disorders have a causal effect on strokes (OR 1.07, 95% CI 1.03-1.11) and ischemic strokes (OR 1.09, 95% CI 1.04-1.13) -- not the other way around.

"Our results, by showing that mood disorders were causally linked with risk of stroke, bring forth the importance of an early screening of mood disorders, facilitating not only the risk stratification, identification of possibly undiagnosed, faster and earlier treatment of individuals of mood disorders, but also ultimately preventing the substantial consequences of strokes for the subjects and society in general," Gonçalves and colleagues concluded.

They suggested PRS as "an ideal and simple approach to identify high-risk subjects at very early stages as germline DNA is measurable even before birth."

Mood disordersopens in a new tab or window, also known as affective disorders, most often involve depression, bipolar disorder, and seasonal affective disorder. Affected individuals have been known to have cardiovascular disease as a frequent comorbid condition, the researchers noted.

For example, a recent reportopens in a new tab or window showed that self-reported depressive symptoms were associated with a significantly greater risk of acute stroke, including ischemic stroke and intracerebral hemorrhage in the subsequent 12 months. Depressive symptoms were also tied to greater likelihood of mortality during the first month after stroke.

Gonçalves and colleagues said their PRS for mood disorders was based on the latest large genome-wide association studies of mood disorders. To date, 73 loci had been associated with risk for mood disorders.

The connection between mood disorders and stroke was assessed in the Malmö Diet and Cancer cohort of 24,631 individuals with a median follow-up of 21.3 years. Participants had baseline examinations from 1991 to 1996 and subsequent stroke events captured on national registers.

The average age of the 24,366 stroke-free participants at baseline was 58 years, and approximately 40% were women.

Mendelian randomization analysis relied on summary statistics from large genome-wide association studies of the Psychiatric Genomics Consortium and the MEGASTROKE Consortium. This technique minimizes residual confounding and reverse causality by using genetic variants as instrumental variables to estimate potential causal effects.

"PRS and MR [Mendelian randomization] are less likely influenced by confounding factors over time, since the germline DNA is also relatively stable across the lifespan. Thereby, the path of reverse causations from outcomes to instruments is very unlikely," Gonçalves' group explained.

The study nevertheless lacked the level of detail necessary to analyze the link between mood disorders and the individual subtypes of stroke, the researchers noted. Moreover, the reported associations between the mood disorders and strokes may differ in other populations comprised of different ethnicities.

Nicole Lou is a reporter for MedPage Today, where she covers cardiology news and other developments in medicine. Follow

Disclosures

The study was supported by the Swedish Stroke Association, Söderström König Foundation, Hjelt Diabetes Foundation, Swedish Research Council, Swedish Heart and Lung Foundation, Skåne University Hospital Foundation, Lund University Diabetes Center - Industrial Research Center from the Swedish Foundation of Strategic Research, Region Skåne Grants, Swedish Stroke Foundation, Swedish Society of Medicine, Emil and Wera Cornell Foundation, and Diabetes Research and Wellness Foundation Sweden.

Gonçalves and colleagues had no disclosures.

Primary Source

Stroke

Source Reference: opens in a new tab or windowSun J, et al "Genetic susceptibility to mood disorders and risk of stroke: a polygenic risk score and Mendelian randomization study" Stroke 2023; DOI: 10.1161/STROKEAHA.122.041026.